Gestational amniotic embolism: rapid diagnosis, care protocols, and multidisciplinary team response in emergencies

Abstract

Gestational amniotic fluid embolism is a rare and severe obstetric emergency, resulting from the entry of amniotic fluid into the maternal circulation, leading to cardiogenic shock, disseminated intravascular coagulation (DIC), and high mortality risk. The diagnosis is clinical, based on symptoms such as sudden dyspnea, hypotension, and coagulopathy. Risk factors include advanced maternal age and emergency cesarean sections. The treatment is supportive and requires a rapid response and a multidisciplinary approach. With mortality above 60%, amniotic fluid embolism involves a systemic inflammatory response similar to anaphylaxis. The differential diagnosis includes pulmonary embolism and anaphylaxis, and the treatment involves ventilatory support, hemodynamic stabilization, and coagulation correction. The multidisciplinary team's role optimizes care. A systematic review based on the PRISMA method was conducted, searching databases like PubMed and LILACS, considering studies on early diagnosis, care protocols, and multidisciplinary action. Early diagnosis is challenging, requiring rapid identification and exclusion of differential diagnoses. The multidisciplinary team, including nurses, plays a crucial role in patient stabilization. Ongoing training and care flowcharts improve clinical response. Amniotic fluid embolism requires immediate recognition and effective protocols. Multidisciplinary action and continuous training are essential to improve maternal-fetal outcomes and reduce mortality.